United Kingdom

South African Covid mutation poses 're-infection risk' which could overpower vaccines, study finds

The South African coronavirus mutation poses a 'significant re-infection risk' and could overpower vaccines, new research has found.

The strains discovered in Britain, South Africa and Brazil all have mutations of a spike protein, which enables the virus to latch onto human cells and therefore plays a key role in driving infections.

But it is one mutation in particular - known as E484K and present in the variants from South Africa and Brazil - that has experts worried about immunity 'escape'. 

Researchers in South Africa tested the variant found there - called 501Y.V2 - against blood plasma from recovered Covid-19 patients.

They found it was resistant to neutralising antibodies built up from prior infection, meaning that it could also defy immunity provided by the current crop of jabs. 

Sir Patrick Vallance, the UK's chief scientific adviser, held a television Q&A with members of the public on Sky News this morning

'Here we show that the 501Y.V2 lineage, which contains nine spike mutations and rapidly emerged in South Africa during the second half of 2020, is largely resistant to neutralising antibodies elicited by infection with previously circulating lineages,' the authors said.

'This suggests that, despite the many people who have already been infected with SARS-CoV-2 globally and are presumed to have accumulated some level of immunity, new variants such as 501Y.V2 pose a significant re-infection risk.'

The researchers added that this might also affect the use of convalescent plasma as a treatment for Covid-19.

They also referred to 'implications' for vaccines developed based on immune responses to the virus's spike protein. 

Has Britain got its Pfizer vaccine strategy wrong?

Israel's top coronavirus medic has claimed the first dose of Pfizer 's Covid vaccine is less effective than he expected.

Dr Nachman Ash, one of the medics leading the Covid-19 response in Israel, said the first instalment of the jab did not cut infection rates as much as he had hoped.

He told local media Army Radio: 'Many people have been infected between the first and second injections of the vaccine,' but it can take 10 days or more for the immunity to kick in.

Real-world data from Israel's world-beating rollout showed the first dose led to a 33 per cent reduction in cases of coronavirus between 14 and 21 days afterwards in people who got the jab. Another of the country's top doctors said it was 'really good news'.

But the figure is lower than the British regulator's estimate, which said it may prevent 89 per cent of recipients from getting Covid-19 symptoms.  

However, Israel's data does not prove anything about possible impacts of the UK's controversial 12-week gap between doses. The country does not give any more than three weeks between the first and second doses, during which time protection is expected to be minimal at best – and the vaccine is not intended to prevent infection, but severe disease and death.

Sir Patrick Vallance, the UK's chief scientific adviser, today said he would expect all vaccines to be less effective in the real world than in trials. He added that Britain should look 'very carefully' at data during the vaccine rollout to see what effect its having.

It comes after Sir Patrick Vallance admitted there were still 'question marks' over whether the vaccines would work against the South African and Brazilian strains.

No10's chief scientific adviser added it was 'quite likely' Britons may need to get a Covid jab every winter for 'at least a few years'. 

However, Sir Patrick was able to say emphatically that the so-called Kent variant, first found in England, would be dealt with by the vaccines. 

Trevor Bedford of the Fred Hutchinson Research Center said the South African variant could 'spread more widely in the coming months'.

If the results of the new research are confirmed, he said it may be necessary to adapt the virus 'strain' used in developing the vaccine by autumn of this year.

He said real world immune responses were more complex than those of the blood plasma neutralising antibodies.

'The vaccines do stimulate very strong responses, immunity is a sliding scale, it's not an on/off switch,' he added. 

Two other preliminary studies posted on Wednesday found that the antibodies from previously-infected patients are largely effective against the variant detected in Britain and that the BioNTech/Pfizer vaccine appears to be guard against it as well.

The vaccines being rolled out now are based on versions of the constantly-evolving virus studied a year ago, so may become less effective as more mutations occur over time.

Cambridge University microbiologist Dr Ravi Gupta yesterday told MailOnline 'the time has come' to start making updated vaccines to tackle common concerning mutations that have cropped up in multiple unconnected variants around the world.

Moderna said it was confident its jab will work against the England and South Africa variants and it will carry out more tests on the Brazilian one. Oxford University said it was running checks on its own jab.

Pfizer today said the it was 'unlikely' that the B.1.1.7 lineage — the Kent variant — will evade the vaccine. Studies of a lab-made version of the variant was neutralised by antibodies created by the jab. 

The drug giant's results come after another variation of the coronavirus was found in Germany, although scientists don't yet know if it is any more infectious or deadly.

And there are signs the English variant of the virus has been spreading in the US for two months already, with it likely to have been in California as early as November 6. 

The major concerns about the Kent, South Africa and Brazil variants of the virus are that they are now widespread and significantly different to earlier versions, to which many people have developed immunity.

Kent's variant is the one least likely to drive down the efficacy of a vaccine because it is missing a mutation found on the other two.

The Brazilian and South African variants share a mutation called E484K, which is thought to change the shape of the spike protein on the outside of the virus so much that immune system antibodies in many people are unable to recognise it.

Researchers have not yet done tests on how the immune system of someone who has had a Covid vaccine would respond to those versions of the virus.

When asked about variants and vaccines in a television Q&A on Sky News this morning, Sir Patrick said: 'On the variant that was first identified in Kent, I think we're increasingly of the view that that variant will be susceptible to the vaccine and to previous immunity. 

'The studies are all pointing in that direction so I think that's good in terms of vaccine effect.

'For some of the others that are popping up around the world – and they will continue to pop up – we've still got some question marks as to how effective a vaccine will be. 

'Those studies need to be continued and I think it's likely that we will need to have modified vaccines in due course.'

The reason new variants may be able to get past the immune system is that the substances the body makes to tackle viruses are extremely specific and fit to the virus like a key in a lock.

These substances, the main type of which are antibodies, can be made by someone catching the virus for real or being injected with a vaccine.

If the virus changes shape too much – and it is constantly changing because of random errors when it reproduces, even though many of these changes make no difference – the immune system won't be able to attach to it.

Companies and scientists making the current crop of vaccines insist that their vaccines will still work as intended, at least on the Kent variant also known as B.1.1.7.   

Pfizer and BioNTech scientists yesterday published a paper that said it was 'unlikely that the B.1.1.7 lineage will escape [vaccine]-mediated protection'.

The team exposed the virus to the blood of 16 people who had been enrolled in trials of the companies' vaccine to see if the immune cells would recognise and destroy it.

When they compared the immune reaction to this Kent variant with the reaction to the original virus from Wuhan they said there was 'no biologically significant difference in neutralization activity'.

Coronavirus variant found in Germany

Another mutated coronavirus variant has been found in Germany, different to those originating in the UK, South Africa and Brazil.

Health officials said the variant was identified in Bavarian hospital patients, but it isn't yet known how transmissible it is or whether it makes Covid worse.

Concerns have grown in recent weeks over the spread of the variants, the UK-based version of which forced Boris Johnson to cancel Christmas for millions and plunge the nation into a third national lockdown. 

Discovery of the new German strain has also seen Angela Merkel take action, with the Chancellor declaring restrictions including the closure of schools and shops will be extended until mid-February.

Germany's infection rate has stabilised in recent days, indicating that existing restrictions may have been effective in bringing down the numbers. 

The variant was found in 35 out of 73 newly infected people at Garmisch-Partenkirchen, in the southeast of the country.

Experts continue to analyse samples after Clemens Stockklausner, deputy medical director at the Charité university hospital in Berlin, admitted it was too early to say whether this virus was more deadly than other variants.

He said: 'At the moment we have discovered a small point mutation… and it is absolutely not clear whether it will be of clinical relevance.

'We have to wait for the complete sequencing.' 

Moderna said in a statement: 'The Moderna Covid-19 Vaccine expresses the full-length spike protein of the SARS-CoV-2 virus, allowing for the generation of neutralizing antibody responses to multiple domains of the protein. 

'The full-length Spike protein is 1,273 amino acids long, so while recent variants involve multiple mutations, for instance up to eight amino acid changes in the spike protein of the B.1.1.7 strain, these represent less than a one per cent difference from the spike protein encoded by Moderna's vaccine.

'While we plan to run tests to confirm the activity of the vaccine against any strain, the broad range of potential neutralizing antibodies made possible by the Moderna Covid-19 Vaccine provide confidence that our vaccine will also be effective at inducing neutralizing antibodies against them.' 

An AstraZeneca spokesperson said: 'The University of Oxford and labs across the world are carefully assessing the impact of new variants on vaccine effectiveness, and starting the processes needed for rapid development of adjusted Covid-19 vaccines if these should be necessary.' 

While the claim that Pfizer's jab will still work against the variant is good news for Britain, where it is now the dominant strain, it is also good for the US, which has seen it spread widely with research now suggesting it has been there since November.

University of Arizona researchers studied the genomes of 50 B.1.1.7 infections in the US and traced their lineage to determine when the mutated variant first appeared in the US. 

They found two clusters of infections, one in California and one in Florida, which originated on November 6 and November 23 respectively – the first being roughly six weeks before SAGE told the government about the new variant and health secretary Matt Hancock announced it to the public. 

This retrospective study has the benefit of genomic analysis and hindsight, and the first actual case of the Kent strain was not diagnosed in an American until December 29. 

'It is striking that this lineage may already have been established in the US for some 5-6 weeks before B.1.1.7 was first identified as a variant of concern in the UK in mid-December,' the researchers write. 

'And it may have been circulating in the US for close to two months before it was first detected, on 29 December 2020.'

Greater concern about the effectiveness of vaccines is swirling around mutations that emerged in South Africa and Brazil, which carry an extra mutation called E484K.

This mutation has been linked in early scientific studies to 'immune escape' and may make the antibodies of some people significantly less effective at destroying it.

South African academics found that 48 per cent of blood samples from people who had been infected in the past did not show an immune response to the new variant. 

Professor Penny Moore, the researcher behind the project, claimed people who were sicker with coronavirus the first time and had a stronger immune response appeared less likely to get reinfected.

She told a scientific panel meeting earlier this week: 'When you test the blood of people infected in the first wave and you ask 'Do those antibodies in that blood recognise the new virus?' you find that in 50 per cent of cases – nearly half of cases – there's no longer any recognition of the new variant.

'In the other half of those individuals, however, there is some recognition that remains. I should add those are normally people who were incredibly ill, hospitalised and mounted a very robust response to the virus.'

Professor Moore said that research made it 'clear that we do have a problem', but that it is still in its early stages and laboratory studies cannot perfectly recreate the real world.

On whether vaccines would be affected, she added: 'If you have very high antibodies to begin with, there does remain some recognition of the new virus and that's important as we think about vaccines.

'Some vaccines elicit very high levels of antibodies and others do not, so we need to understand whether there is some recognition by vaccine-elicited, rather than infection-elicited, antibodies.'

The inevitable mutation of the virus could mean that vaccines have to be updated, redeveloped and given out every year in the same way that flu jabs are.

Sir Patrick said: 'I think that will be something that's going to be a regular feature of this.

'Fortunately the new vaccine technology, particularly the messenger RNA vaccines [Pfizer and Moderna], are relatively easier to change and you can almost dial up a change. It then takes a few weeks for that to be made and come through, so it's not instantaneous, but I think that's what's going to come through.

'I wouldn't be at all surprised if, from time to time, we need to get slight variations of the vaccine in order to make sure we keep on top of this, and I think changes in the virus will occur all over the world. 

'Viruses mutate, that's what they do, and I would expect to see more and more of that as we go forward.'

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